Monday, June 18, 2012

Part 2: Pay Bone Marrow Donors?

As will be evident inthis podcast, Myra Christopher and I do not agree on the question of compensation
for marrow or blood stem cells "donation."

I think we would agree (do we?) that federal policy ought not to be driven by
one heart-rending case, as depicted in the Rock Center with Brian Williams piece from June 14, 2012.

It also seems to me less than civil and fair to depict those who disagree with
compensation proposals, like Dr Boo of the National Marrow Donor Program, as
simply cold-hearted rationalists (and possibly self-interested). That is what
NBC's Dr Snyderman appeared to be doing, however. Hardly a stellar bit of
journalism, in my opinion.

Yet the issue is quite interesting, even as the particular case (the Flynn
family) is tragic and troubling. It is noted by the journalist that the Flynn
twins had controversially been conceived, using IVF procedures and
pre-implantation genetic diagnosis, specifically for the purpose of becoming
their older sister's marrow and stem cells donors.

I think they glossed over,
however, some ethical implications of the fact that this normative stretch, by
Kantian measures, yielded the unintended consequences of the twins themselves
having Fanconi anemia. So now there are three children in need of a stem cell
transplant, and not just the one.

The mother's response? To propose yet another normative stretch, or break:
Reclassify marrow as a non-organ blood product, hence not subject to NOTA (1984
law), and commodify stem cells from marrow and blood.

Dr Boo and most BMT physicians asked thus far are opposed, in part on grounds
of reaping further unintended consequences including that of a possible net
loss of available stem cell donors for transplantation.

Some of us also think it is begging the question, a circular argument, to claim
that it ought to be permissible to pay marrow "donors" on grounds
that we already do so for human plasma, sperm, ova, hair, and loaner wombs for
surrogate pregnancy. Perhaps, instead, we ought not to pay anyone for any human
body part or product?

I wish that Dr Snyderman, Brian Williams and Rock Center had done a bit of
ethics in the process of reporting a sad story with a moralistic spin.

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The Center for Practical Bioethics is a nonprofit, free-standing and independent organization nationally recognized for its work in practical bioethics. Since 1984, the Center has helped patients and their families, healthcare professionals, policymakers and corporate leaders grapple with ethically complex issues in medicine and research.
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